National School District Wellness Coalition New District Application

National School District Wellness Coalition New District Application
Welcome to the National School District Wellness Coalition. This form is to be filled out by one member from each district to help us ensure we have your most current contact information, as well as a little bit of information about your school district.
Your Name*

First NameLast Name
Job Title*
Email*
example@example.com
Phone Number
Each district has a "district lead." This person is our main point of contact for the district. They will be responsible for updating contact information as it changes over time.
Are you the district lead (main point of contact for NSDWC)?*

YesNo
If no, please enter the name of the district lead here:
School District*
City*
State*
Geographic classification*

RuralUrbanOther
District size*

Small (less than 5,000 students)Medium (between 5,000 and 40,000 students)Large (more than 40,000 students)
How many schools are in your district?*
How many students are in your district?*
Please copy and paste your district's website URL here:
How did you first learn about the NSDWC?
By filling out this form, you are committing to membership in the National School District Wellness Coalition. Members are expected to attend monthly virtual meetings and annual in-person convenings, keep their contact information up to date, and contribute to the Coalition by occasionally presenting, serving as a panelist, or sharing their experience and expertise in other ways as they are able.*

I understand and accept.

WSCC Component Leads

We understand that not every district will have a designated person for each WSCC component. Larger districts may have more NSDWC members. You can always add or remove members from this list as you need to. Adding people to this list ensures that they will receive email communications from NSDWC. We recommend having members participate in the coalition that are responsible for various areas of the  Whole School, Whole Community, Whole Child (WSCC) model such as social-emotional learning or PE specialists, school nutrition directors, school nurses, etc. as well as other district administrators (e.g., superintendents, assistant superintendents, etc.).
Please use the space below to identify any administrators or staff in your district who will be engaging with the Coalition under each applicable WSCC component:

Other
Use this space to list the names, titles, and emails of any other coalition members in your district:

As we welcome you into NSDWC, we'd love to learn a little more about your district.
Areas of district strength:*
Self-identified areas of improvement:*
One problem of practice we struggle with where we would welcome additional support:*
We are most interested in engaging with the Coalition because:*
Some topics our team might be interested in presenting on throughout the year:*
Other fun facts or information we'd like to share:
Please upload a team/district photo for our virtual directory.

Browse Files

Cancelof
Should be Empty:

WSCC Component Leads